1720188089 NPI number — DR. STEVEN MARK SILVERS DO

Table of content: DR. STEVEN MARK SILVERS DO (NPI 1720188089)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1720188089 NPI number — DR. STEVEN MARK SILVERS DO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SILVERS
Provider First Name:
STEVEN
Provider Middle Name:
MARK
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DO
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SILVERS
Provider Other First Name:
STEVEN
Provider Other Middle Name:
MARK
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
DO
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1720188089
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/13/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4302 ALTON ROAD
Provider Second Line Business Mailing Address:
460
Provider Business Mailing Address City Name:
MIAMI BEACH
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33140-2893
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
305-535-9600
Provider Business Mailing Address Fax Number:
305-672-6843

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4302 ALTON ROAD
Provider Second Line Business Practice Location Address:
460
Provider Business Practice Location Address City Name:
MIAMI BEACH
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33140-2893
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
305-535-9600
Provider Business Practice Location Address Fax Number:
305-672-6843
Provider Enumeration Date:
09/25/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207V00000X , with the licence number:  OS4929 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 061382700 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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